Many tracers have been introduced into current medical practice with the purpose of improving lymphatic mapping techniques, anatomic visualization, and organ/tissue perfusion assessment. Among them, three tracers have dominated the field: indocyanine green, technetium-99m radiocolloid (Tc99m), and blue dye. Tc99m and blue dye are used individually or in combination; however, given particular challenges with these tracers, such as the need for a preoperative procedure by nuclear medicine and cost, other options have been sought. Indocyanine green has proven to be a promising alternative for certain procedures, as it is easy to use and has quick uptake. Its use in the management of gynecologic cancers was first described for sentinel lymph node mapping in cervical cancer, and later for endometrial and vulvar cancers. This review provides an in-depth look at these mapping substances, their uses, and the potential for new discoveries.
- surgical procedures
- vulvar and vaginal cancer
- uterine cancer
- cervical cancer
- sentinel lymph node
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Editor's note This paper will feature in a special issue on sentinel lymph node mapping in 2020.
Twitter @jackiefeinberg, @leitaomd
Contributors All authors have contributed significantly to warrant authorship.
Funding This study was funded by National Cancer Institute.
Competing interests Outside the submitted work, ML is an ad-hoc speaker for Intuitive Surgical.
Patient consent for publication Not required.
Provenance and peer review Commissioned; externally peer reviewed.